Any Ortho Spine PA's out there???

[MEDwar44]

I will be starting PA school this fall at UAB, and currently I hold a lot of interests in a plethora of areas in medicine. However, I was recently approached by two third year Ortho residents and asked if when I finish school would I ever consider working spine with them. Now, granted I have a long ways to go before I start talking jobs or officially being a PA...but I'm curious could any Ortho spine PA's out there share their experience working in Ortho spine? Do you like it? Do you have a good amount of autonomy both clinically and operatively? What's your perspective for a student getting ready to start this fall and trying to just think about potential areas of interest in the future.

 

Thanks

[Hallcrest]

Considering an ortho spine for elective clinical rotation - please chime in any ortho-spine PA's. 

I would like to hear about split of time between clinic/OR in your practice, your responsibilities in each, average hours in a work week, etc. Thanks any who respond -

[acozadd]

I work in general ortho, but our group did have an ortho spine surgeon for a period of time that I scrubbed a few cases with. My general observations were that the cases were long, tedious, boring. The patient population is unvaried and often unpleasant. With that said, some people love it and I believe that it is a very well compensated specialty that that may translate into better PA salaries. Perhaps my opinion is a bit jaded because I REALLY enjoy general ortho, so take my comments with a grain of salt.

[Hallcrest]

thanks for your response aco -

would you mind speaking a little about the clinic vs OR split time in your current role, and a bit about total hours per week, call, etc?

[BruceBanner]

I started my PA career in ortho spine. I would not advise it. Here's why:

 

-Long, tedious cases where you are an over-paid retractor holder. The longest case we had was about 8-9 hours but a typical case was 3-4. Standing, bent over a table. And then you get to do rounds and orders afterwards. 

-In surgery you will always be an assistant.

-If they take trauma call this can suck big time. 

-You end up being a bit of a "gopher". There are a hundred ancillary hospital tasks that need to be done and they usually get delegated to the lowest man (or woman) on the totem pole. Stuff like D/C summaries, weekend rounds, consults, direct admits, scripts, orthotics, refills, etc

-Clinic is seeing follow-ups, removing staples, sutures, etc.

-Perhaps the most important reason is---unless you stay in spine forever---it will set you back years in your career. A PA without general medicine/primary care experience is a very tough sell to employers, and should you find you don't like spine you will have to start from scratch and potentially take bottom-of-the-barrel gigs like low T clinics, weight loss clinics, grocery story runny nose clinics, etc.

 

 

Don't be seduced by the pay.

[MelanieJ]

I'm a neurosurgery PA that will soon transition to Ortho spine. I don't agree about spine PAs not having general medicine experience. Of all the cases that neurosurgery or ortho spine does and has in the hospital during the week, you will definitely manage their blood pressure, electrolytes, DM, etc. Not all spine cases are 1 day outpatient. Hospital medicine PAs don't manage critical care patients most times but as a specialty surgery PA you will have a hand in both. In neurosurgery, my time is spent between clinic, hospital, hospital on-call and OR. You do all of this! And I have my own clinic, with my own patient load and discuss difficult things with my SP and my patients go to the SP when they need surgery, I handle all the conservative management. There are tons of patients who would rather see you than the physician. Over-paid retractor holder? That's a possibility with some doctors. Or you could be the one opening a separate incision, making a pocket for a spinal cord stimulator battery and closing on mostly all cases. It all depends on your skills and your physician.